8455-FID Form Fillable California e-file Payment Record for Fiduciaries
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

First Payment Second Payment Third Payment Fourth Payment 1 2014 Total Income (Form 541 line 9) 1 2 Tax Due (Form 541 line 34) 2 3 Electronic Funds Withdrawal Amount 4 Withdrawal Date (mm/dd/yyyy) 5 Amount 6 Withdrawal Date 7 Routing number 8 Account number 8455 FID 9 Type of account: m Checking m Savings banking records Be sure the banking information is correct before transmitting your tax return If the bank or financial institution rejects the electronic funds California e file Payment Record for Fiduciaries copy of form FTB 8455 FID or a comparable form at the time you sign form FTB 8879 FID Form FTB 8455 FID does not serve as proof of filing DO NOT MAIL THIS FORM TO THE FTB For Privacy Notice get FTB 1131 ENG/SP Form FTB 8455 FID California e file Payment Record for Fiduciaries is a summary of electronic funds withdrawals that you have authorized FTB 8455 FID 2014 General Information If you cancel a payment you are still liable for any amount you owe Make your payments by the due dates to avoid a late payment penalty For KEEP THIS FORM FOR YOUR RECORDS DO NOT MAIL TO THE FRANCHISE TAX BOARD (FTB) least two working days before the scheduled date of the payment more payment options go to ftb ca gov and search for payment options Name and title of fiduciary Name of estate or trust FEIN or proof of payment Your proof of filing is the acknowledgement containing the date we accepted your tax return Your proof of payment is your Part I Tax Return Information (Whole Dollars Only) Part II Return Payment Information for Taxable Year 2014 Part III Scheduled Estimated Tax Payments for Taxable Year 2015 These are NOT installments of the current amount you owe Part IV Banking Information for Electronic Funds Withdrawals from Parts II and III TAXABLE YEAR To cancel your tax return payment or an estimated tax payment you must call FTB e Programs Customer Service at 916 845 0353 at with your 2014 e file tax return as part of your California e file Signature Authorization for Fiduciaries (form FTB 8879 FID) You are to receive a withdrawal due to an error in the routing number or account number we will send you a notice that may include penalties and interest